The present invention is directed to a threadform for use in threadedly joining together two elements and, in particular, to a threadform for joining together medical implants. The threadform includes a leading surface and a trailing surface, both of which slant rearwardly and away from the direction of advancement from an inner edge to an outer edge thereof.
Medical implants present a number of problems to both surgeons installing implants and to engineers designing them. It is always desirable to have the implant be strong and unlikely to fail or break during usage. It is also desirable for the implant to be as small and lightweight as possible so that it is less intrusive on the patient. These are normally conflicting goals, and often difficult to resolve.
One particular type of implant presents special problems. In particular, spinal bone screws, hooks, etc. are used in many types of back surgery for repair of injury, disease or congenital defect. For example, spinal bone screws of this type are designed to have one end that inserts threadably into a vertebra and a head at an opposite end thereof. The head is designed to receive a rod or rod-like member which is then both captured in the head and locked in the head to prevent relative movement between the various elements subsequent to installation.
There are two different major types of bone screws and similar devices. The types are closed head and open head. The closed head devices are highly effective at capturing the rod since the rod is threaded through an opening in the head. Unfortunately, closed head devices are very difficult to work with in actual surgery as the spine is curved and the rods are also curved in order to follow the spine. Consequently, the more heads that the rod must pass through, the more difficult it is to thread it.
The second type of head is an open head wherein a channel is formed in the head and the rod is simply laid in an open channel. The channel is then closed with a closure. The open headed bone screws and related devices are much easier to use and in some situations must be used over the closed headed devices.
While the open headed devices are often necessary and often preferred for usage, there is a significant problem associated with them. That is, the open headed devices conventionally have two upstanding arms that are on opposite sides of a channel that receives the rod member. In order to lock the rod member in place, significant forces must be exerted on a relatively small device. The forces are required to provide enough torque to insure that the rod member is locked in place relative to the bone screw so that it does not move axially or rotationally therein. This typically requires torques on the order of 100 inch pounds.
Because the bone screws, hooks and the like are relatively small, the arms that extend upwardly at the head can be easily bent by radially outward directed forces due to the application of substantial forces required to lock the rod member. Historically, early closures were simple plugs that were threaded and which screwed into mating threads on the inside of each of the arms. However, conventionally threaded plugs push the arms radially outward upon the application of a significant amount of torque which ends up bending the arms sufficiently to allow the threads to disengage and the closure to fail. To counter this various engineering techniques were applied to allow the head to resist the spreading force. For example, the arms were significantly strengthened by increasing the width of the arms by many times. This had the unfortunate effect of substantially increasing the weight and the size of the implant, which was undesirable. Many prior art devices have also attempted to provide rings or some other type of structure that goes about the outside of the arms to better hold the arms in place while the center plug is installed. This additional structure has typically caused the locking strength of the plug being reduced which is undesirable. Also, the additional elements are unfavorable from a point of view of implants, as it typically desirable to maintain the number parts associated with the implants at a minimum.
Consequently, a lightweight and low profile closure plug was desired that resists spreading of the arms while also not requiring additional elements that circle around the outside of the arms so as to hold the arms in place.